The Role of the Systemic Inflammatory Response in Predicting Outcome in Patients with Pancreatic Cancer

Abstract

Although pancreatic cancer is only the tenth most common cancer, it is the sixth most common cause of cancer death in the United States (Jemal et al. 2007). In the UK, each year there are approximately 7,000 cases of pancreatic cancer and a ­similar number of deaths from the disease. The outlook of these patients remains poor having the lowest, 5-year survival rate of any cancer, being approximately 5% (Cancerstats, www.cancerresearchuk.org).

Pancreatic adenocarcinoma accounts for approximately 80% of all pancreatic cancers. At the time of initial presentation, less than 20% of the patients presenting with pancreatic adenocarcinoma will have operable disease due to local invasion of the adjacent blood vessels, lymphatics, and nerves, or metastatic spread to liver or peritoneum. Although surgery remains the only proven approach for improving survival in patients with pancreatic cancer, it is complicated and is associated with appreciable morbidity and mortality. As a consequence, potentially curative surgery is carried out relatively infrequently and usually in a specialist center. Nevertheless, 5-year survival rates in these patients are commonly less than 25%, and therefore the benefit of radical resection in some patients is not clear.